come on and cover me....

I had a call from my medical insurer today, checking that everything was okay with my renewal.

Well. Hmmm.

I never planned to have medical insurance at all; I acquired it as a non-contractual benefit when I was outsourced in 2004, but didn’t really think anything of it until I actually needed to use it. When I woke up that summer morning in 2005 with a numb hand and made an appointment to see my doctor, I was starting a journey that would take something like 4 years and require many visits to a few different neurologists in different hospitals, several diagnostic MRI scans, lots of blood tests, an evoked potentials test and, finally, the lumbar puncture that confirmed my diagnosis with multiple sclerosis.

As I’m sure you can imagine, those first few months and visits to see the neurologist were pretty scary, and I was very glad that I had medical insurance in-hand to make sure that there were no delays in getting the best available diagnostic assessment. Not knowing what is wrong was far, far more worrying and stressful - for me at least - than actually being told I had MS.  About halfway through that diagnostic process and still firmly in limboland healthwise, I was earmarked for outsource again – well, insource actually, back into the company that originally outsourced me. Whatever. Except that suddenly, I had a reason to care: this one did not provide medical insurance as a non-contractual benefit. Continuing my existing medical cover was apparently impossible, but now I was sitting on a "pre-existing", undiagnosed condition that significantly complicated getting a new provider.  You try getting an insurance company to take on a liability of unknown size without receiving a pretty hefty quote back.  Yeah.  Exactly.

HR, true to form, did not care and refused to see how this was any of their concern– my existing medical cover was a non-contractual benefit from my old company that they didn’t offer and were under no legal obligation to provide. Why would you expect your Human Resources Department to display any empathy with human beings, right?  My new company did have an arrangement with a medical insurer, but now I was looking at the thick end of £50 a month for basic cover, or £100 a month if I wanted to cover my undiagnosed condition…which of course I did. More than a grand a year just because my stupid damn employer couldn’t make up their minds about how they wanted to be structured and did the hokey-cokey with my career. So much for the 'people people' caring about people.

Luckily for me, I found someone else in my department - one of our leadership team - who cared enough about my situation to arrange for a permanent salary bump the equivalent of the £50 a month to cover the basic medical insurance and a one-off payment to cover a year’s worth of the difference to the full cover… this guy had no need to do this for me, but when I thanked him for his efforts on my behalf, he told me that the really sad thing was that he’d actually had to do very little to make it happen. Well, at least he cared enough to do that much... and I've not forgotten it.

So there it is. I ended up with medical cover that cost me around £100 a month that covered me for everything, including the thing that was eventually diagnosed as my MS. That £100 is now nearer £150 (although, much to my amusement, my courtesy call today included the marvellous information that the annual increase to my policy wasn’t as much as it would have been because I’ve used my policy so little. His exact phrase was that “you’ve had a reduction on your annual increase”. Still an increase, mind…. But a reduced increase. Like a minor gun-shot wound, I suppose. Better than a major one, but still a gun-shot wound.

Anyone reading this in the USA is likely already rolling their eyes at my health insurance ‘problems’…. But it gets even better. As soon as I was diagnosed with multiple sclerosis, I fell into the capable care of the National Health Service: all of my diagnostics, treatments and consultations are now entirely free to me… not least the drugs that I inject each week at a cost of more than £1000 a month. I was seeing a neurologist privately at the time, but I immediately began to see the same consultant on the NHS. In fact, a colleague of mine who had the same symptoms as me at the same time (and ended up with the same diagnosis) saw the same consultant on the NHS with no wait and was actually diagnosed and treated on much quicker timescales than me!

But still I pay for private medical insurance. They cover a condition that I don’t think I actually need covering, but for some reason I’m reluctant to let that cover go as I know it is likely to be excluded elsewhere.

I can afford the cover, so I guess it’s a nice problem to have…. But it still seems ridiculous.  Not least because I could be covered under C's company insurance (she's important enough to get it), but I'm reluctant to have my cover tied to her continuing employment with this company.

Hmmf.

It’s not all bad though. I ended up having my eyes done in the same hospital where I saw that private neurologist. I was expecting to pay in full, but as they knew all my insurance details, they just ran it through that and it all went through. That’s a couple of years of subscription covered, I guess.  If I end up needing surgery on my knee, that will be covered too, as are all my various trips to the osteopath and/or physio.  It doesn't amount to the money I pay in subscription, I suppose.... and I'd maybe be better off just paying directly as and when needed... but it's there if I need it.

I'm an idiot, right?

If there is a moral to this story, it is simply that the NHS is amazing: my private insurance has not given me an iota of better healthcare, or access to better doctors or better equipment than the NHS would have provided for me; as soon as I was diagnosed, the NHS took up the heavy-lifting and are paying for everything without question.  I don't know if my insurance company would have signed up to more than £1000 worth of drugs a month, perhaps for the rest of my life, but the NHS stepped in without question and even offered me a choice from the various disease modifying drugs on offer.  Money never came into it.  I know that the coverage in the NHS varies from region to region, and from condition to condition (my own neurologist told me that Nottingham is brilliant if you have MS, but terrible if you have epilepsy)... it's certainly not perfect, but it is still entirely remarkable.  Healthcare free at the point of access to everyone: this is an amazing, precious thing and we should cherish it and work to protect it.

The Supreme Court of Justice in the USA has just ruled that the Individual Mandate that underpins Obama's Healthcare policy is lawful, hopefully opening the door to affordable, tax-subsidised healthcare for everyone.  Good, right?  Seems to make sense to me, and yet it is facing vehement opposition - even by some of those who stand to benefit the most - who seem to think that it's the beginning of the end of the world.

People are fascinating, they really are.